Biomedical subjects
Publications and source records attributed to M Livingston.
Schizophrenia has a lifetime expectancy of about 1 per cent and the GP can be involved in management at all stages. One important role is counselling and support for the family. In the drug treatment of schizophrenia, it is useful to become familiar with two or three drugs.
This is the first comparative double blind study of remoxipride. Sixty-one patients with acute schizophrenia received either remoxipride (75-375 mg daily) or thioridazine (150-750 mg daily) for 6 weeks. There was no statistically significant between-drug difference in improvement in mental state, as measured by the Brief Psychiatric Rating Scale, although the trend favoured thioridazine; global assessment of illness severity at the last rating also favoured thioridazine. Sedation, anticholinergic effects, autonomic dysfunction and weight gain were significantly more common in patients receiving thioridazine. Both drugs produced few extrapyramidal effects, but both produced cardiovascular changes in two patients; neither drug produced significant abnormalities in laboratory tests.
A wide range of antipsychotic drugs is available. This paper reviews the profile of action of such drugs, the rationale for their use, and current prescribing practice. The treatment of psychotic illness in the future, with drugs, may be possible without causing unwanted movement disorder.
This review describes the impact of illness on patients' families and the importance of this for doctors who wish to involve relatives in rehabilitation programmes. It is essential that studies of such impact employ reliable methodology in assessing patient outcome and relatives' functioning.
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As part of a randomized trial of the effects of 1 year of exercise training on patients with stable coronary artery disease, 48 patients who exercised and 59 control patients had computerized exercise electrocardiography performed initially and 1 year later. The patients who had exercise training as an intervention had a 9% increase in measured maximal oxygen consumption and significant decreases in heart rate at rest and during submaximal exercise. ST segment displacement was analyzed 60 ms after the end of the QRS complex in the three-dimensional X, Y and Z leads and utilizing the spatial amplitude derived from them. Statistical analysis by t testing yielded no significant differences between the groups except for less ST segment displacement at a matched work load, but this could be explained by a lowered heart rate. Analysis of variance yielded some minor differences within clinical subgroups, particularly in the spatial analysis. Obvious changes in exercise-induced ST segment depression could not be demonstrated in this heterogeneous group of selected volunteers with coronary artery disease secondary to an exercise program.
A sample of 173 female nurses was studied to assess the amount of stress they experienced whilst at work. Psychological symptoms were found to be commoner in younger, less experienced nurses spending more time with patients. Suggestions are made to reduce distress in vulnerable nurses.
Four cases are described in which the drug mianserin was implicated in the development of leucopenia. In one case this was accompanied by fatal aplastic anaemia. In a second, generalized bone marrow depression occurred, although leucopenia was the only clinically significant manifestation. Mianserin may depress bone marrow function and haematological surveillance is appropriate for patients taking this drug.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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There is a growing movement towards more casual uniforms within paediatric nursing. However, children's and parents' preferences should be considered before deciding what type nurses should be wearing.
To determine if Kaposi's sarcoma-associated herpesvirus (KSHV) prevalence is correlated with the 9-fold difference in the incidence of classic Kaposi's sarcoma observed among Israeli Jewish populations, we conducted a cross-sectional KSHV seroprevalence survey in a population of 166 HIV-seronegative healthy subjects from the general population (26 women, 140 men). Eight individuals (4.8%) (all men) were seropositive for KSHV; differences between men and women were not statistically significant. If we consider the sensitivity and specificity of the assays, the corrected prevalence would be 6.1% (95% confidence interval 2.0-10.1). We noticed a non-statistically 5.5-fold difference between individuals above and below 40 years of age, but did not find an association with the incidence of classic KS among the Israeli Jewish sub-population, according to their origin. This suggests that KSHV is only necessary, albeit not sufficient, cause of classic Kaposi's sarcoma.
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OBJECTIVES: (1) To examine the effects of exercise alone and the additional benefit of a teaching-counseling program with exercise when compared with usual medical and nursing care on the rate of return to previous activities, and (2) to describe the rates of return to former activities of daily living after an acute myocardial infarction. DESIGN: Prospective randomized clinical trial. SETTING: Seven Northwestern hospitals. SAMPLE: 258 patients, 70 years of age or younger, with the diagnosis of acute myocardial infarction, admitted to coronary care units of participating hospitals. OUTCOME MEASURES: Return to work, sexual activity, driving, previous maximum level of activity, and activities out of the home. INTERVENTION: Subjects were randomly assigned to control group A, which received usual medical and nursing care; group B1, which received usual care plus exercise; or group B2, usual care plus exercise plus teaching-counseling sessions. Home exercise programs were prescribed for patients in groups B1 and B2. Those in group B2 also participated in the outpatient teaching-counseling program that consisted of eight group sessions pertaining to risk factor reduction and psychosocial adjustment to myocardial infarction. All subjects completed Activity Summary Questionnaires, a 12-item self-report paper and pencil questionnaire about the week's activity, each week, for 12 consecutive weeks, and at week 24 after hospital discharge. RESULTS: There were no significant differences between the three groups. Previously employed patients who returned to work did so by week 24. Patients who returned to their previous maximum level of activity resumed by week 24. Most patients returned to sexual activity, driving, and activities out of the house by week 12. CONCLUSIONS: The rates of return to activities were not significantly different between the three groups. Most patients were active earlier than previously reported. Over 50% of patients returned to sexual activity, driving, and outdoor activities by 3 weeks after acute myocardial infarction. These results are useful for health care professionals who counsel patients about expectations in activity resumption.